Treating Acute Pain and Inflammation
You’ve been injured. You rolled your ankle or twisted your knee. Or, you’re my age and you sneezed aggressively and pulled a muscle in your back. Whatever the case, what’s the best way to treat an acute injury and the subsequent inflammation?
It boils down to a debate about R.I.C.E. or M.E.A.T. No, this isn’t another vegetarian vs carnivore debate.
For the longest time, the advice for an acute has been to use the R.I.C.E protocol, which stands for Rest, Ice, Compression, and Elevation. On the surface (key theme here), this makes sense. You roll your ankle- you see it ballon up- the immediate instinct is to grab some ice, put some compression on it and elevate it to keep the swelling down.
In addition, anti-inflammatories and pain relieving medications like Ibuprofen and other Non-Steroidal Anti-Inflammatories are (NSAIDS) are recommended.
What if this is the wrong advice?
This is still accepted in many places as the best approach, but new evidence suggests it is slowing the healing process.
The Healing Process
After an injury, the swelling occurs as an increase of blood flow rushes to the area to help the area heal. Too much ice will slow the healing process because it restricts blood flow. Using ice numbs the surface so it feels good, but it will slow the healing.
Anti-inflammatory medications will produce quicker pain relief in the short term but it will take longer to resolve the issue completely(1). The new research is beginning to link the use of anti-inflammatories to the cause of chronic pain. Shutting doe the inflammation early on may be leading to the development of chronic pain becuase the acute injuries are not allowed to fully resolve.
So what’s the alternative. Let’s check in with Homer Simpson for an answer:
The M.E.A.T. protocol stands for Movement, Exercise, Analgesics, Treatment. Keep the injured area moving, exercise when appropriate, take proper analgesics and get treatment(2)
Treatment may include Physical Therapy, stretching, strengthening, ice, heat and of course, Acupuncture.
In regards to analgesics- the recommendation is to use natural pain relievers like Turmeric or Capsaicin and not the type of medications used to tamp down the inflammation or shut down the immune response.
So What are you to do? Since there is no definitive one answer, we typically recommend icing for the first 24-72 hours but not longer than 10 minutes at a time. After the 72 hours maximum, move onto using heat in the area.
Our Approach in Clinic
In the clinic, our first approach is Acupuncture (obviously). Acupuncture is naturally anti-inflammatory and works by improving blood flow. Bringing nutritious fresh blood to an area promotes healing by delivering pain killing chemicals, reducing swelling, clearing out lymph fluids and cellular debris. We also have other techniques, like cupping, gua sha, vibrational massage and photobiomodulaton (PBM).
A quick note on PBM- by utilizing an LED device with near infrared light- we are able to treat an injured area without touching it. The PBM device reduces inflammation and edema, reduces pain and promotes healing.
In the clinic we have two topical pain relievers that also help to promote healing. We use them in isolation but they can compound each other when used together. These are made using the highest quality herbs available.
Evil Bone Water: promotes circulation, reduces pain, strengthens connective tissue, promotes bone healing
Corydalis Salve: reduces pain, swelling, bruising, inflammation, and muscle spams
These 2 are available in the office. If you’re curious, give us a call at 781 944 3000.
If you have questions about an injury you’re dealing with, please call the clinic at 781 944 3000.
(1) Are anti-inflammatory drugs causing chronic pain?
(2) MEAT Protocol MEAT Protocol